Best implant in the nose Goretex, silicone for the Asian Patient

Goretex implants for Asian Plastic Surgeryare usually made out of sheets and are formed by the surgeon to fit the nasal characteristics of the patient.  Goretex is made up of fibrillated polymer of polytetrafluoroethylene with pore sizes in the range of 22um which allow limited tissue in growth. It has been determined that pore sizes between 1 and 50 um (micrometers) will allow bacteria to get into the pores but not tissue ingrowth to fight off the bacteria.  Hence pore sizes between 1-50 um are not supposed to be good.  But there are a lot of surgeons that have used gore tex in the nose without a lot of problems and it has a proven track record in the nose.  It is a soft implant and allows the tissue to fixate the implant for a more stable feel.  Theoretically the chance of extrusion or rejection of these implants versus silicone should be higher and some studies show that is the case but the chances of this is still pretty low.  I have a good colleague that is very well known and totally believes this is the best implant to use in the nose.  I however based on experience and knowledge of different products believe that silicone is the best implant for the nose during Rhinoplasty.  It is the most compatible of all implants and has a lot of characteristics that come close to the ideal implant.  It allows limited tissue ingrowth but is very stable. Some people believe that the implants allow to much movement, are not as stable, and can look unnatural.  There are ways to fix the implant to the deeper structures that make the implant feel as if it were bone in certain places such as in the nasal dorsum/ bridge.  The silicone implant can also be placed within the tip in a judicious way to augment the tip, raise it and shape it with great success.  The alternative to this is to harvest cartilage from the septum or ear with the drawbacks of these areas. Septal cartilage is sometimes sparse in the asian nose and ear cartilage is often times too flimsy and curvy for the nose. Rib cartilage is sometimes the best natural alternative for the bridge and all the other areas an Asian nose might need.

Dr Young is located in Bellevue near Seattle, Washington

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